Jaundice is the yellow colour seen in the skin and in the white part of the eyes of many newborn infants.

It happens when a chemical called bilirubin builds up in the baby’s blood, due to immaturity of the liver.

Most newborn babies develop jaundice to some degree in the first few days. Usually, it is not serious and does not cause any harm. In most cases, jaundice in babies goes away after a week or two without any treatment.

Prolonged jaundice is when the yellow colour skin does not fade after two weeks in a full-term baby, and after three weeks in a premature baby. Prolonged jaundice is usually harmless, but can be a sign of a serious liver problem.

Your midwife, health visitor or GP can diagnose prolonged jaundice by looking at your baby’s skin and eyes in a well-lit room.

They will then refer your baby to see our doctors at one of our clinics at Barnet Hospital or the Royal Free Hospital to investigate the cause of their prolonged jaundice. 

The symptoms of jaundice and prolonged jaundice are: 

  • The skin looking slightly yellow, a bit like a suntan. In babies with dark skin, the yellowing can be noticed more easily on the soles of their feet, their palms and/or inside their mouth. 
  • The whites of the eyes being yellow. 

Most babies with jaundice do not have any other symptoms, but some may also: 

  • have dark urine (wee) 
  • have pale stools (poo) instead of yellow or green 
  • be excessively sleepy 
  • not be feeding well

Jaundice

Most cases of jaundice are caused by the baby’s liver not being able to work fast enough when they are born.

One of the functions of the liver is to remove bilirubin from the blood. Bilirubin is a yellow chemical that is made when red blood cells that are no longer needed are broken down. 

Because newborn babies have more red blood cells than older children and these cells do not last as long, newborns make more bilirubin, and their liver cannot process it all. This means bilirubin builds up in their blood and causes jaundice.

Babies who are breastfed often stay jaundiced for longer than bottle-fed babies. If this is the case, the jaundice will fade with time and the baby should continue to be breastfed. 

Prolonged jaundice

Prolonged jaundice can be caused by: 

  • A condition where the red blood cells break down more quickly than normal. However, this is usually recognised during pregnancy or very soon after birth. 
  • An infection or other illness. 
  • A problem with your baby’s thyroid gland. 
  • A liver problem, but this is rare. 

At the prolonged jaundice clinic, we will ask you questions about your pregnancy, your baby’s birth and how your baby has been feeding. 

You will also be asked about the colour of your baby’s stools (poo) and urine (wee) and if any of your baby’s relatives have had jaundice. 

Your baby may be weighed, and it is likely they will have a blood test to check the jaundice levels. For this, we will prick their heel prick to take a small amount of their blood. You can feed your baby during this time to comfort them. 

If the results are OK, we will contact you by phone and advise you on further management. 

If the results suggest that your baby has a severe prolonged jaundice or liver problem, we will contact you by phone to tell you this. If this is the case your baby may need to have more blood tests, an ultrasound scan of their liver and treatment if they need it.

Healthcare professionals can refer patients to our prolonged jaundice clinics via the following emails:

rf-tr.prolongedjaundicereferrals@nhs.net (Camden area)

rf-tr.galaxychildrensclinic@nhs.net (Barnet and Enfield areas)